Shoulder joint pain can range from mild to severe, depending on the underlying cause. Some possible causes include osteoarthritis of the shoulder, a rotator cuff tear, bursitis, and shoulder joint instability.

There are many conditions that can cause shoulder joint pain. Some conditions specifically affect the shoulders, while others may affect other areas of the body.

This article focuses mainly on the causes of shoulder pain that primarily affect the shoulder joint and surrounding tissue. It also lists the symptoms of shoulder joint pain, tips for managing it, and more.

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Shoulder pain may be dull or sharp and can vary from mild to severe, depending on the cause.

People may find that the pain worsens with general movement or only occur when they make certain movements or bear weight on their shoulders.

The shoulder may also lose some mobility and feel stiff and swollen, making it difficult to perform everyday tasks.

The rotator cuff comprises four muscles that surround the upper arm bone called the humerus.

Rotator cuff tears are a common cause of shoulder pain, resulting in about 2 million doctor consultations each year in the United States.

It can result from a sudden injury or degenerative causes. Degenerative causes of a tear can include:

  • wear and tear
  • aging
  • long-term overuse

The tear may be partial, with small tears, or complete, where the tendon completely separates from the bone.

Symptoms can include:

  • weakness when lifting or rotating the arm
  • pain due to lifting and lowering the arm
  • a sensation of popping in the shoulder joint following movement
  • pain that occurs when at rest or at night and may worsen when laying on the shoulder

Treatment

Treatment for rotator cuff tears will vary according to the extent of the tear, age, overall health, and a person’s activity level. These approaches can range from rest to surgical intervention.

Some common types include:

  • nonsteroidal anti-inflammatory drugs (NSAIDs)
  • rest
  • changes to activities
  • steroid injections
  • surgical repair

OA is the most common form of arthritis and generally has associations with injury or wear and tear.

According to the Arthritis Foundation, although OA is more common in the hip or knees, about 1 in 3 people over 60 years of age have OA of the shoulder.

The onset is generally slow, developing over several years.

The most common symptom of osteoarthritis is pain, which worsens with movement and progresses over time. The pain will eventually continue at night and interfere with sleep.

Other symptoms can include a clicking or cracking noise when moving, loss of mobility, and stiffness.

Treatment

There is no way to cure osteoarthritis, but a person can take steps to manage the pain.

Some treatment options include:

  • pain relievers, such as:
    • acetaminophen
    • anti-inflammatories, such as NSAIDs
    • corticosteroids
  • braces
  • physical therapy
  • hot or cold therapy
  • flexibility and strength training
  • massage
  • medicated creams

A person may also require surgery as a last resort.

Tendinitis refers to inflammation and swelling of the tendons in the shoulder. It often affects the rotator cuff tendons.

Tendinitis can be either acute or chronic. Acute means that the pain has a sudden onset following an injury, while chronic means that the pain is due to long-term wear and tear.

A person will experience tenderness and swelling at the front of the shoulder that radiates to the side of the arm. They will also experience pain and stiffness when lifting and lowering the arm.

The initial symptoms of tendinitis can be mild. However, as the condition progresses, a person experiences:

  • pain during the night
  • loss of strength
  • loss of motion

Treatment

Treatment for tendinitis may include:

  • NSAIDs
  • physical therapy
  • cortisone injections
  • surgical intervention
  • rest and changes to activities

Shoulder instability often occurs due to injury to the tissue or bones in the shoulder. It causes the humerus bone to dislocate from the socket joint.

It can cause the following symptoms:

  • limited range of motion
  • pain
  • weakness
  • stiffness in the shoulder
  • tenderness
  • grinding or clicking sensation
  • tingling or burning sensation

Young, athletic people have a higher risk of developing the condition.

Treatment

Treatments for tendinitis can vary but may include:

  • immobilization of the shoulder
  • avoiding activities that aggravate it
  • physical therapy
  • surgical correction

Bursae are small, fluid-filled sacs that develop in the joints throughout the body, including the shoulders. They cushion the joints and help them move smoothly.

Excessive use of the shoulder joint can cause swelling and inflammation. It is a common cause of shoulder pain.

Pain is a common symptom of bursitis. It may occur when at rest or may worsen with activities such as:

  • lifting arms to the side
  • rotating the arms
  • applying downward pressure to the shoulders

The pain may occur on the outside or top of the shoulders.

Treatment

Treatment for bursitis will depend on the severity of the condition.

For some, exercises, including stretch and resistance training, rest, and ice, may be enough. Others may need additional medical care, which may include the use of pain relievers and, in severe cases, surgery.

Shoulder impingement occurs when the muscles and tendons of the rotator cuff catch on the acromion, the bony tip of the top of the shoulder blade. Lifting the arm can compress the space between the two body parts, causing more pain and irritation.

The main symptom is sudden or acute pain when reaching behind the back or above the head. A person may also experience:

  • weakness
  • constant, dull pain in the shoulder or arm
  • worsening pain at night

Treatment

Treatments can vary according to the severity of the condition. They typically involve using NSAIDs to help control pain and inflammation.

A doctor may also recommend physical therapy or surgical correction in more severe cases.

Several bones make up the shoulder. Any one of them can break or fracture, causing pain, weakness, and the potential loss of movement or mobility.

A fracture often occurs due to blunt force trauma. This can include falls or sudden impacts, such as from contact sports or a car accident.

In addition to pain, a person may experience:

  • swelling
  • warmth
  • loss of mobility
  • bruising
  • an inability to move the shoulder
  • a grinding sensation when a person moves the shoulder

Treatment

Treatment for fractures often involves aligning the bones as necessary and casting to immobilize the shoulder. A person may also need surgery.

Doctors may prescribe or recommend pain and anti-inflammatory medications.

A person may be able to manage shoulder pain at home. However, if symptoms do not improve, they can consult a medical professional for diagnosis.

Some potential ways to manage shoulder pain can include:

  • rest
  • cold or hot therapy
  • strength or flexibility training
  • over-the-counter pain relievers or NSAIDs
  • practicing good posture
  • modifying a person’s activities

A person can contact a doctor if their shoulder pain does not go away following rest and other home treatments.

They should visit an emergency room or seek immediate treatment following an acute injury or in cases of severe pain.

Diagnosis will vary according to what a doctor or other medical professional believes may be the underlying cause.

During a visit, a doctor will likely:

  • assess a person’s range of motion
  • discuss their pain level and location
  • check for tenderness and the strength of the shoulder
  • examine the area with an X-ray or other imaging techniques

Shoulder joint pain can occur due to various reasons, such as bursitis, OA, and a torn rotator cuff.

Treatments will depend on the underlying cause. However, it typically involves rest, ice or heat therapy, and pain medications.

In severe cases, a doctor may recommend surgical intervention.